R-6: Personal and Environmental Factors Influencing Community Living for People with Disabilities

Sample

For this study we will analyze a community participation dataset that was collected using web-based surveys of people with disabilities, CORE and SPARC, in 2007-2010. The dataset includes 692 people from the United States recruited using a convenience sample methodology, from solicitations made to a variety of organizations that work with people with disabilities. All were between the ages of 18 and 75, lived in the community, could read at or above the 6th grade level, could enter responses into a web-based survey or direct another individual to enter their responses into a web-based survey, and had a mobility impairment, visual impairment or a hearing impairment (see appendices 2-sample demographics and 3- geographic distribution of sample).

The number of respondents is large for statistical purposes and the samples of the impairment groups (vision – 147, hearing – 135, and mobility – 410) are also of reasonable size and are proportional to the population. We expect the power to detect meaningful statistical differences to be high.

Data Collection and Measurement

This project uses a dataset collected using the SPARC and CORE, measures of community participation among people with disabilities that were, developed under the existing RRTC/MICL. The dataset is a national sample of community participation among adults with mobility impairments, visual impairments or hearing impairments. The Characteristics of the Respondent (CORE) was designed to help researchers understand what personal factors influence participation for people with disabilities. The survey includes questions about demographics, geography by residential address, income and benefits received, health status, any disabling conditions (physical impairment, visual impairment or hearing impairment), primary diagnosis for each identified disabling condition, and any current or past secondary conditions (see Table 1).

Table 1: Items included in the CORE
Demographic	Geographic	Disabling Condition
Age, Race, Gender & Ethnicity Education level & Employment Employment & Housing Transportation used Marital Status Living Status – alone or with others Family income Individual’s Current Benefits- Social Security, Medicare Medicaid, & Independent Living Services	Rural Urban Residential address Community site by street address	Impairment group Diagnosis Severity Length of time-disability Health status Health service use Secondary condition Personal assistance use – general Device use - general

The Survey of Participation and Receptivity in Communities (SPARC) is an instrument used to identify facilitators to participation in the community from the perspective of people with impairments and limitations. The SPARC includes questions on the frequency of participation at 19 specific community sites (see Table 2).

Table 2: Sites in the Survey of Participation and Receptivity in Communities (SPARC)
Your Home Grocery Store Pharmacy Places of Worship Restaurants Visiting Home of Friends/Family Places You Work, Volunteer, or Attend Classes	Large Stores Gas Stations Doctor’s Office Museums/Landmarks Public Parks Exercise Facilities	Sports Arenas Movie Theaters Shopping Malls Beauty Salon or Barber Shop DME* Vendors and Suppliers Transportation
*Durable Medical Equipment

Participants were asked about their community participation with respect to: frequency, importance, control, choice, satisfaction, personal factors (pain and fatigue), magnitude and frequency of support used to do activities (use of assistance and use of assistive technologies), 17 physical features at each site, 8 types of interpersonal responses of people at the site, and use of transportation to visit the site. If the participants indicated the site was important for them to visit but that they did not visit that site, the participants were asked to identify reasons for not visiting (see Table 3 below).

Table 3: SPARC questions for visited and not visited community sites.
	Reason(s) for not visiting sites
Participation	Frequency Importance Choice Control Satisfaction	Have no interest Do not need to go Not enough money Fatigue Pain
Health	Pain Fatigue	Use home services No transportation
Facilitators	Physical features Positive reception	Not accessible No unpaid personal assistance
Barriers	Negative reception	No paid assistance
Supports	PAS and/or AT	Background noise
Transportation	Personal or public	Treated poorly by employees

Data Analysis

In this project, we will measure the effects of socio-demographic, geographic factors and community characteristics, and type of disability on community participation. We will use SPSS version 19.0 to conduct data analysis, including descriptive statistics and correlations. Where there are a sufficient number of responses in each category of the independent variable(s), we propose to utilize a multivariate analysis of variance (MANOVA) statistical technique. For example, to test the hypothesis that the evaluation by a respondent at a visit to their doctor’s office will differ across disability subgroups, there will be four dependent variables (importance, choice, control and satisfaction) and three levels of an independent variable (vision, hearing, mobility). Where significant main effects are determined, post hoc analyses will include the examination of discriminant functions and univariate analyses using the Sheffe method. Similar analyses will be performed for hypothesis 2 with the same dependent variables. However, the independent variables will be socio-demographic and geographic factors using disability severity as a covariate.